A woman in Maryland is sharing her story after surviving an aneurysm rupture, only to find that she had five total aneurysms that needed to be operated on.
Ilona Downs-Hicks told TODAY that she first realized something was wrong when she experienced a painful headache in the middle of the night in August 2021.
"I just had a feeling that something was wrong, because when the pain hit me, it made me freeze in place for maybe 15 to 20 seconds," Downs-Hicks recalled. "I knew that it was not a regular headache or migraine."
Downs-Hicks sought treatment at a local hospital, where she was diagnosed with a single aneurysm and given resources about where to pursue further treatment. Downs-Hicks made the requisite appointments, but said she was "scared to death" about what the future might hold, especially after another doctor indicated that she might have two aneurysms, not one.
The week before a scheduled procedure to clip the aneurysm in October, it burst while she was sitting in her car at her job. Downs-Hicks said she had a severe headache, trouble keeping her right eye open and difficulty speaking.
"It was so scary," Downs-Hicks recalled. "I've never, ever been through anything like this, ever. I didn't know what was going on with my body. I couldn't even call out to anybody ... I didn't have a voice and it scared me to death. I just felt in my brain that I was going to die."
Downs-Hicks was able to wave and get the attention of a coworker, who called 911. Downs-Hicks was rushed to the University of Maryland Medical Center, where she was operated on by Dr. Mohamed Labib, a neurosurgeon. Labib said that Downs-Hicks was already in the intensive care unit when he met her, and the aneurysm had ruptured, causing one eye to close.
Labib and the medical center's neurovascular teams were able to clip both aneurysms in a microscopic surgical procedure, allowing Downs-Hicks to regain the use of her eyes and safely return home shortly afterwards.
“I always tell my patients that about a third of patients who have an aneurysm rupture do not make it to the hospital, and then a third of those who make it to the hospital do not do well after any intervention, because the rupture was so bad,” Labib, who is also a professor of neurosurgery at the University of Maryland School of Medicine, explained. "And then a third of those who make it to the hospital actually survive it and do well."
Labib said that Downs-Hicks fell into that third category and recovered from the procedure well and regained control over her eye. However, a follow-up exam found that Downs-Hicks didn't have just two aneurysms: In another part of her brain there were three aneurysms, which hadn't ruptured but were still a threat. The medical team made a plan to operate.
"It was a little nerve-wracking," said Downs-Hicks, of the weeks between when the three new aneurysms were discovered. "But the thing is, I was calm. I didn't have the pain that I experienced before the first surgery."
Labib said that Downs-Hicks' second surgery was again successful. He told TODAY that in general, surviving aneurysms is rare — but surviving five is "taking it to a different level."
"Five is a little bit too much. ... Five is the highest I have ever treated in one patient," Labib said. "And someone doing well after having multiple aneurysms in general is not a very common thing."
Downs-Hicks said that since her final surgery in December 2021, she has had a positive recovery, and hasn't needed to take measures like physical therapy. She told TODAY that she plans to return to her job as a teacher's assistant in mid-March.
Can aneurysms be prevented?
Labib said that there's no real way to prevent aneurysms, but there are some steps that people can take to know and reduce their risk. The biggest warning sign, he said, is a family history of aneurysms.
"If you have a mother or father, brother or sister in the family who had aneurysms, that's definitely a risk factor, but that is not something you can change," Labib said.
Two things that you can focus on he said are hypertension and smoking, both of which are linked to higher risk of aneurysm development and rupture. However, sometimes aneurysms can develop in otherwise healthy adults and not be detected until they rupture.
"I urge everybody, of course, to take care of their body and health," Labib said. "But the only risk factor we know is scientifically known to modify (your risk) is smoking. ... In general, it's good to take care of your body and your health. But unfortunately, aneurysms are those kinds of things that are like ticking time bombs, and you may not even know you have one."
When should you seek medical help?
Since aneurysms can be undetected and need rapid treatment for the best chance of survival and recovery, Labib said that it is important to know the signs of when you should seek medical care.
One major warning sign, he said, is a sudden, severe headache.
"A small headache is usually not the presentation of aneurysms. What I urge people is if you have a sudden onset of a severe headache, that you consider to be the worst headache you have had in your life, that becomes 10 out of 10 (on a pain scale) all of a sudden out of nowhere, that's a headache that is very concerning," Labib said. "In general, severe headache is the biggest concern."
Labib said that some specific symptoms, like Downs-Hicks' inability to open her eyes, may vary based on where the aneurysm is located and what nerves or parts of the brain it may be impacting.
Other symptoms of a ruptured aneurysm, according to the Mayo Clinic, can include nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, a drooping eyelid, confusion or loss of consciousness.
Symptoms of an unruptured aneurysm can include pain above and behind one eye, a dilated pupil, change in vision or double vision, and numbness on one side of the face.
CORRECTION (March 5, 8:52 AM): An earlier version of this article misstated the hospital that Ilona Downs-Hicks was treated at. It is the University of Maryland Medical Center, not the University of Maryland School of Medicine.